Anemia : treatment for

Recently i have two anemic patients. Aged between 56 and 58. Both are alcoholic. Takes frequent medication for pain abdomen and backache. There hemoglobin was going down and down. No occult blood, GE varices present gr II not bleeding, no ova cyst in stool, not on antiplatelets. Dewarming (one time) and Hematinics did not help much change. I advised them not to take blood transfusion even at HB 4.8 gm% and 6.2 gm%. 

I took them in to confidence that they will eat one AMLA daily (row-crushed, chewed, whatever way), because this is season for amla, one tab of iron and a tab of b complex (the cheapest) in addition to dewarming tab on day one, three, five,  fifteen and thirty.

After 2 months there blood was checked. The hb is 9gm%. Stopped all medicine and AMLA. Hb is rising at slow pace of 1 gm %.

Moral of the story is : 1. donot combine Iron tab with other food. 2. Dewarming by single dose is insufficient. 3. Amla or Vit c is good adjunct in our cases. 4. Cheapest of b complex tab provide enough neccessary vit.